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Individual

DR. MICHAEL THOMAS FITZGERALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9 RICHLAND MEDICAL PARK DR STE 450, COLUMBIA, SC 29203
(803) 434-8800
(803) 434-8802
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
05445
GA
208600000X
Surgery Physician
55848
TN
208600000X
Surgery Physician
Primary
82845
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
828457
SC
Enumeration date
05/29/2012
Last updated
08/27/2019
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